Stroke is the most common life-threatening neurological disease, the clinical
sequelae are serious. The genesis is multifactorial with strong interactions
between genetic and environmental factors. As stroke and its sequelae consume
huge resources of the public health the prevention is of great importance. The
first step for that is the identification of people with high stroke risk to
which more and more alleles of susceptibility are searched for. The von
Willebrand factor (vWF) plays an important role in the interaction of primary
and secondary haemostasis. Various polymorphisms of the gene encoding vWF are
known. The Sma I polymorphism is located in intron 2 of vWF, and is strongly
associated with increased risk of acute ischaemic stroke in a Chinese case-
control study. But until now there is no investigation of this association in
a Caucasian population. It is merely known that the allele frequencies between
both ethnic groups differ considerably. In a geriatric hospital in Berlin, 140
patients with non-cardioembolic cerebral infarction and 209 control subjects
of the same age were recruited and examined for the Sma I polymorphism. The
aim of the present case-control study was to determine the correlation between
that polymorphism and ischaemic strokes among Caucasians as well as to compare
the result with the Chinese study. The prevalence of the CC genotype in stroke
patients was not significantly higher than that of the controls (OR=1.14;
p=0.56). As well there was no significant difference with regard to the
frequencies for the C allele (OR=1.21; p=0.41) that correspond in both groups
to the published frequency among Caucasians. Even after exclusion of the
stroke patients without documented carotid atherosclerosis there was a trend
to a higher prevalence of the CC genotype, but no significance (OR=1.32;
p=0.25). However, a significant difference regarding the genotype prevalences
was found between the Berlin population and the Chinese one (p=0.018). In
conclusion, the Sma I polymorphism in the vWF gene is not associated with non-
cardiogenic cerebral infarction in a Berlin population. With it, this
population differs significantly from a Chinese one. That polymorphism may
represent a risk factor for ischaemic stroke in Chinese, but not in
Caucasians. This result joins numerous moleculargenetic investigations into
the correlation between haemostatic factors and atherothrombosis or
atherosclerosis which altogether showed inconsistent results.